Femoral shaft strains during daily activities: Implications for atypical femoral fractures
Femoral shaft strains during daily activities: Implications for atypical femoral fractures
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DOI：
10.1016/j.clinbiomech.2014.08.001
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发表时间：
2014-09-01
影响因子：
1.8
通讯作者：
Ebeling, Peter R.
中科院分区：
文献类型：
--
作者：
Martelli, Saulo;Pivonka, Peter;Ebeling, Peter R.
背景：非典型股骨骨折是起始于股骨干外侧的低能量骨折。我们假设非典型股骨骨折的发生与日常股骨应变模式有关。我们检查了日常活动中的股骨干应变。方法：我们根据来自单个捐赠者的解剖学上一致的肌肉骨骼和有限元模型以及来自身体匹配志愿者的运动记录，分析了步行、坐立和从椅子上起身、上楼梯、下楼梯、上楼梯和蹲下时股骨应变的早期计算结果。提取不同活动的股骨干中的股骨应变并进行比较。采用多参数线性回归分析研究了股骨外侧轴应变与动力学参数之间的相关性。结果：股骨外侧轴拉伸应变从 327 mu epsilon（蹲着）到 2004 mu epsilon（行走）变化。步行和下楼梯对侧轴施加拉力载荷，而其他活动主要对前轴施加拉力载荷。多参数线性回归显示，横向轴的拉伸应变与近端轴 (R-2 = 0.60) 和远端轴 (R-2 = 0.46) 的运动动力学（关节力矩和地面反作用力）之间存在中等强度的相关性。 解释：承受拉伸应变的骨区域与非典型股骨骨折相关。步行是引起外侧股骨干最大拉伸应变的日常活动。运动动力学解释了横轴中 46%-50% 的拉伸应变变化，而无法解释的部分可能归因于关节力矩分解为肌肉力的方式。 (C) 2014 Elsevier Ltd. 保留所有权利。
Background: Atypical femoral fractures are low-energy fractures initiating in the lateral femoral shaft. We hypothesized that atypical femoral fracture onset is associated with daily femoral strain patterns. We examined femoral shaft strains during daily activities.Methods: We analyzed earlier calculations of femoral strain during walking, sitting and rising from a chair, stair ascent, stair descent, stepping up, and squatting based on anatomically consistent musculoskeletal and finite-element models from a single donor and motion recordings from a body-matched volunteer. Femoral strains in the femoral shaft were extracted for the different activities and compared. The dependency between femoral strains in the lateral shaft and kinetic parameters was studied using multi-parametric linear regression analysis.Findings: Tensile strain in the lateral femoral shaft varied from 327 mu epsilon (squatting) to 2004 mu epsilon (walking). Walking and stair descent imposed tensile loading on the lateral shaft, whereas the other activities mainly imposed tensile loads on the anterior shaft. The multi-parametric linear regression showed a moderately strong correlation between tensile strains in the lateral shaft and the motion kinetic (joint moments and ground reaction force) in the proximal (R-2 = 0.60) and the distal shaft (R-2 = 0.46).Interpretation: Bone regions subjected to tensile strains are associated with atypical femoral fractures. Walking is the daily activity that induces the highest tensile strain in the lateral femoral shaft. The kinetics of motion explains 46%-50% of the tensile strain variation in the lateral shaft, whereas the unexplained part is likely to be attributed to the way joint moments are decomposed into muscle forces. (C) 2014 Elsevier Ltd. All rights reserved.